BACKGROUND Coronavirus disease 2019(COVID-19),which recently spread throughout the entire world,is still a significant health issue.Additionally,the most common cause of risky poisoning in emergency services is carbon...BACKGROUND Coronavirus disease 2019(COVID-19),which recently spread throughout the entire world,is still a significant health issue.Additionally,the most common cause of risky poisoning in emergency services is carbon monoxide(CO)poisoning.Both disorders seem to merit more research as they have an impact on all bodily systems via the lungs.AIM To determine how arterial blood gas and carboxyhemoglobin(COHb)levels affect the clinical and prognostic results of individuals requiring emergency treatment who have both COVID-19 and CO poisoning.METHODS Between January 2018 and December 2021,479 CO-poisoning patients participated in this single-center,retrospective study.Patients were primarily divided into two groups for analysis:Pre-pandemic and pandemic periods.Additionally,the pandemic era was divided into categories based on the presence of COVID-19 and,if present,the clinical severity of the infection.The hospital information system was used to extract patient demographic,clinical,arterial blood gas,COVID-19 polymerase chain reaction,and other laboratory data.RESULTS The mean age of the 479 patients was 54.93±11.51 years,and 187(39%)were female.226(47%)patients were in the pandemic group and 143(30%)of them had a history of COVID-19.While the mean potential of hydrogen(pH)in arterial blood gas of all patients was 7.28±0.15,it was 7.35±0.10 in the pre-pandemic group and 7.05±0.16 in the severe group during the pandemic period(P<0.001).COHb was 23.98±4.19%in the outpatients and 45.26%±3.19%in the mortality group(P<0.001).Partial arterial oxygen pressure(PaO2)was 89.63±7.62 mmHg in the pre-pandemic group,and 79.50±7.18 mmHg in the severe group during the pandemic period(P<0.001).Despite the fact that mortality occurred in 35(7%)of all cases,pandemic cases accounted for 30 of these deaths(85.7%)(P<0.001).The association between COHb,troponin,lactate,partial arterial pressure of carbon dioxide,HCO3,calcium,glucose,age,pH,PaO2,potassium,sodium,and base excess levels in the pre-pandemic and pandemic groups was statistically significant in univariate linear analysis.CONCLUSION Air exchange barrier disruption caused by COVID-19 may have pulmonary consequences.In patients with a history of pandemic COVID-19,clinical results and survival are considerably unfavorable in cases of CO poisoning.展开更多
This work presents the use of extended Modified Lambert Beer(MLB)model for accurate andcontinuous monitoring of percent blood carboxyhemoglobin(COHb)(SCO)and oxyhemoglobin(OxyHb)saturation(SO,)via a fitting procedure....This work presents the use of extended Modified Lambert Beer(MLB)model for accurate andcontinuous monitoring of percent blood carboxyhemoglobin(COHb)(SCO)and oxyhemoglobin(OxyHb)saturation(SO,)via a fitting procedure.This quantification technique is based on theabsorption characteristics of hemoglobin derivatives in the wavelength range of 520-600 nm togive the best estimates of the required parameters.A comparison of the performance of the developed model and MILB law is made using attenuation data from Monte Carlo simulations for a two-layered skin model.The results revealed a lower mean absolute error of 0.4%in the valuesestimated by the developed model as compared to 10%that is given by the MILB law.This studyshowed that the discussed approach is able to provide consistent and accurate measurement ofblood SO,and SCO across diferent skin pigmen tations suggesting that it may potentially be usedas an alternative means for clinical diagnosis of carbon monoxide(CO)poisoning.展开更多
Background The heme oxygenase/carbon monoxide （HO/CO） system plays an important role in the development of hepatic fibrosis. The level of the HO/CO can be directly obtained by determining the carboxyhemoglobin （COH...Background The heme oxygenase/carbon monoxide （HO/CO） system plays an important role in the development of hepatic fibrosis. The level of the HO/CO can be directly obtained by determining the carboxyhemoglobin （COHb） level. The aims of this study were to reveal the significance of COHb in patients with hepatitis B virus-related cirrhosis （HBC） complicated by hepatic encephalopathy （HE）, and to further investigate the influence of the HO/CO pathway on the end-stage cirrhosis, hoping to find a reliable indicator to evaluate the course of HBC. Methods According to the diagnostic criteria, 63 HBC inpatients with HE were enrolled in group H. Patients regaining awareness with current therapies were categorized into group P-H. Comparisons were made with a control group （group N） consisting of 20 health volunteers. The levels of COHb, partial pressure of oxygen （PaO2） and oxygen saturation （SaO2） were determined by arterial blood gas analysis method. The incidences of hepatorenal syndrome （HRS）, upper gastrointestinal bleeding, esophagogastric varices and spontaneous bacterial peritonitis （SBP） in group H were recorded. COHb levels in different groups were compared, and the correlations of COHb levels with HE grades （I, II, III, and IV）, PaO2, SaO2 and hypoxemia were analyzed. Results The COHb level in group P-H （（1.672＋0.761）%） was significantly higher than that in group N （（0.983±0.231）%） （P 〈0.01 ）, and the level in group H （（2.102±1.021）%） was significantly higher than groups P-H and N （P 〈0.01 ）. A positive correlation was observed between the COHb concentration and the grade of HE （rs=0.357, P=-0.004）. There were no significant differences of COHb levels between HE patients with and without complications such as esophagogastric varices （（2.302±1.072）% vs. （1.802±1.041）%, P 〉0.05） or the occurrence of SBP （（2.960±0.561）% vs. （2.030±1.021）%, P 〉0.05）. Compared with HE patients with HRS, the level of COHb was significantly higher in HE patients without HRS （（2.502±1.073）% vs. （1.981＋1.020）%, P=0.029）. The COHb level had a negative correlation with PaO2 （r=-0.335, P=0.007） while no statistically significant relationship was found with SaO2 （r=-0.071, P 〉0.05）. However, when the above two parameters met the diagnostic criteria of hypoxemia, the COHb concentration increased （（2.621±0.880）% vs. （1.910±0.931）%, P=0.011 ）. Conclusions COHb is a potential candidate to estimate the severity and therapeutic effect of HE. The levels of COHb may be tissue-specific in cirrhotic patients with different complications.展开更多
AIM:To investigate the effects of the heme oxygenase(HO)-1/carbon monoxide system on iron deposition and portal pressure in rats with hepatic fibrosis induced by bile duct ligation(BDL).METHODS:Male Sprague-Dawley rat...AIM:To investigate the effects of the heme oxygenase(HO)-1/carbon monoxide system on iron deposition and portal pressure in rats with hepatic fibrosis induced by bile duct ligation(BDL).METHODS:Male Sprague-Dawley rats were divided randomly into a Sham group,BDL group,Fe group,deferoxamine(DFX) group,zinc protoporphyrin(ZnPP) group and cobalt protoporphyrin(CoPP) group.The levels of HO-1 were detected using different methods.The serum carboxyhemoglobin(COHb),iron,and portal vein pressure(PVP) were also quantified.The plasma and mRNA levels of hepcidin were measured.Hepatic fibrosis and its main pathway were assessed using Van Gieson's stain,hydroxyproline,transforming growth factor-β1(TGF-β1),nuclear factor-E2-related factor 2(Nrf2),matrix metalloproteinase-2(MMP-2) and tissue inhibitor of metalloproteinase-1(TIMP-1).RESULTS:Serum COHb and protein and mRNA expression levels of HO-1 and Nrf2 were increased in the BDL group compared with the Sham group and were much higher in the CoPP group.The ZnPP group showed lower expression of HO-1 and Nrf2 and lower COHb.The levels of iron and PVP were enhanced in the BDL group but were lower in the ZnPP and DFX groups and were higher in the CoPP and Fe groups.Hepcidin levels were higher,whereas superoxide dismutase levels were increased and malonaldehyde levels were decreased in the ZnPP and DFX groups.The ZnPP group also showed inhibited TGF-β1 expression and regulated TIMP-1/MMP-2 expression,as well as obviously attenuated liver fibrosis.CONCLUSION:Reducing hepatic iron deposition and CO levels by inhibiting HO-1 activity though the Nrf2/Keap pathway could be helpful in improving hepatic fibrosis and regulating PVP.展开更多
文摘BACKGROUND Coronavirus disease 2019(COVID-19),which recently spread throughout the entire world,is still a significant health issue.Additionally,the most common cause of risky poisoning in emergency services is carbon monoxide(CO)poisoning.Both disorders seem to merit more research as they have an impact on all bodily systems via the lungs.AIM To determine how arterial blood gas and carboxyhemoglobin(COHb)levels affect the clinical and prognostic results of individuals requiring emergency treatment who have both COVID-19 and CO poisoning.METHODS Between January 2018 and December 2021,479 CO-poisoning patients participated in this single-center,retrospective study.Patients were primarily divided into two groups for analysis:Pre-pandemic and pandemic periods.Additionally,the pandemic era was divided into categories based on the presence of COVID-19 and,if present,the clinical severity of the infection.The hospital information system was used to extract patient demographic,clinical,arterial blood gas,COVID-19 polymerase chain reaction,and other laboratory data.RESULTS The mean age of the 479 patients was 54.93±11.51 years,and 187(39%)were female.226(47%)patients were in the pandemic group and 143(30%)of them had a history of COVID-19.While the mean potential of hydrogen(pH)in arterial blood gas of all patients was 7.28±0.15,it was 7.35±0.10 in the pre-pandemic group and 7.05±0.16 in the severe group during the pandemic period(P<0.001).COHb was 23.98±4.19%in the outpatients and 45.26%±3.19%in the mortality group(P<0.001).Partial arterial oxygen pressure(PaO2)was 89.63±7.62 mmHg in the pre-pandemic group,and 79.50±7.18 mmHg in the severe group during the pandemic period(P<0.001).Despite the fact that mortality occurred in 35(7%)of all cases,pandemic cases accounted for 30 of these deaths(85.7%)(P<0.001).The association between COHb,troponin,lactate,partial arterial pressure of carbon dioxide,HCO3,calcium,glucose,age,pH,PaO2,potassium,sodium,and base excess levels in the pre-pandemic and pandemic groups was statistically significant in univariate linear analysis.CONCLUSION Air exchange barrier disruption caused by COVID-19 may have pulmonary consequences.In patients with a history of pandemic COVID-19,clinical results and survival are considerably unfavorable in cases of CO poisoning.
文摘This work presents the use of extended Modified Lambert Beer(MLB)model for accurate andcontinuous monitoring of percent blood carboxyhemoglobin(COHb)(SCO)and oxyhemoglobin(OxyHb)saturation(SO,)via a fitting procedure.This quantification technique is based on theabsorption characteristics of hemoglobin derivatives in the wavelength range of 520-600 nm togive the best estimates of the required parameters.A comparison of the performance of the developed model and MILB law is made using attenuation data from Monte Carlo simulations for a two-layered skin model.The results revealed a lower mean absolute error of 0.4%in the valuesestimated by the developed model as compared to 10%that is given by the MILB law.This studyshowed that the discussed approach is able to provide consistent and accurate measurement ofblood SO,and SCO across diferent skin pigmen tations suggesting that it may potentially be usedas an alternative means for clinical diagnosis of carbon monoxide(CO)poisoning.
基金This study was supported by grants from the National Natural Science Foundation of China，Science and Technology Project of Dalian City
文摘Background The heme oxygenase/carbon monoxide （HO/CO） system plays an important role in the development of hepatic fibrosis. The level of the HO/CO can be directly obtained by determining the carboxyhemoglobin （COHb） level. The aims of this study were to reveal the significance of COHb in patients with hepatitis B virus-related cirrhosis （HBC） complicated by hepatic encephalopathy （HE）, and to further investigate the influence of the HO/CO pathway on the end-stage cirrhosis, hoping to find a reliable indicator to evaluate the course of HBC. Methods According to the diagnostic criteria, 63 HBC inpatients with HE were enrolled in group H. Patients regaining awareness with current therapies were categorized into group P-H. Comparisons were made with a control group （group N） consisting of 20 health volunteers. The levels of COHb, partial pressure of oxygen （PaO2） and oxygen saturation （SaO2） were determined by arterial blood gas analysis method. The incidences of hepatorenal syndrome （HRS）, upper gastrointestinal bleeding, esophagogastric varices and spontaneous bacterial peritonitis （SBP） in group H were recorded. COHb levels in different groups were compared, and the correlations of COHb levels with HE grades （I, II, III, and IV）, PaO2, SaO2 and hypoxemia were analyzed. Results The COHb level in group P-H （（1.672＋0.761）%） was significantly higher than that in group N （（0.983±0.231）%） （P 〈0.01 ）, and the level in group H （（2.102±1.021）%） was significantly higher than groups P-H and N （P 〈0.01 ）. A positive correlation was observed between the COHb concentration and the grade of HE （rs=0.357, P=-0.004）. There were no significant differences of COHb levels between HE patients with and without complications such as esophagogastric varices （（2.302±1.072）% vs. （1.802±1.041）%, P 〉0.05） or the occurrence of SBP （（2.960±0.561）% vs. （2.030±1.021）%, P 〉0.05）. Compared with HE patients with HRS, the level of COHb was significantly higher in HE patients without HRS （（2.502±1.073）% vs. （1.981＋1.020）%, P=0.029）. The COHb level had a negative correlation with PaO2 （r=-0.335, P=0.007） while no statistically significant relationship was found with SaO2 （r=-0.071, P 〉0.05）. However, when the above two parameters met the diagnostic criteria of hypoxemia, the COHb concentration increased （（2.621±0.880）% vs. （1.910±0.931）%, P=0.011 ）. Conclusions COHb is a potential candidate to estimate the severity and therapeutic effect of HE. The levels of COHb may be tissue-specific in cirrhotic patients with different complications.
基金Supported by Grants from the National Natural Science Foun-dation of China,No. 30970886The Science and Technology Project of Dalian,No. 2010E15SF179the Initial Doctoral funding of Liaoning Province,No. 20121110
文摘AIM:To investigate the effects of the heme oxygenase(HO)-1/carbon monoxide system on iron deposition and portal pressure in rats with hepatic fibrosis induced by bile duct ligation(BDL).METHODS:Male Sprague-Dawley rats were divided randomly into a Sham group,BDL group,Fe group,deferoxamine(DFX) group,zinc protoporphyrin(ZnPP) group and cobalt protoporphyrin(CoPP) group.The levels of HO-1 were detected using different methods.The serum carboxyhemoglobin(COHb),iron,and portal vein pressure(PVP) were also quantified.The plasma and mRNA levels of hepcidin were measured.Hepatic fibrosis and its main pathway were assessed using Van Gieson's stain,hydroxyproline,transforming growth factor-β1(TGF-β1),nuclear factor-E2-related factor 2(Nrf2),matrix metalloproteinase-2(MMP-2) and tissue inhibitor of metalloproteinase-1(TIMP-1).RESULTS:Serum COHb and protein and mRNA expression levels of HO-1 and Nrf2 were increased in the BDL group compared with the Sham group and were much higher in the CoPP group.The ZnPP group showed lower expression of HO-1 and Nrf2 and lower COHb.The levels of iron and PVP were enhanced in the BDL group but were lower in the ZnPP and DFX groups and were higher in the CoPP and Fe groups.Hepcidin levels were higher,whereas superoxide dismutase levels were increased and malonaldehyde levels were decreased in the ZnPP and DFX groups.The ZnPP group also showed inhibited TGF-β1 expression and regulated TIMP-1/MMP-2 expression,as well as obviously attenuated liver fibrosis.CONCLUSION:Reducing hepatic iron deposition and CO levels by inhibiting HO-1 activity though the Nrf2/Keap pathway could be helpful in improving hepatic fibrosis and regulating PVP.
